If you read my article on Skipping Rice Cereal for Babies, then you know that rice cereal may not be the best option for various reasons.
But some doctors recommend it to thicken the baby’s formula or breastmilk in an effort to decrease reflux.
While it does help for some. There may be underlying issues that need to be addressed. I am always a huge advocate of seeking out the reason for a symptom because I believe it will help reduce other issues down the road.
First off, why is your baby spitting up?
Spitting up once or twice a day is common. Spitting up a lot or “excessively” may be common but not normal.
GER (Gastroesophageal reflux) occurs in more than two-thirds of otherwise healthy infants and is the topic of discussion with pediatricians at one-quarter of all routine 6-month infant visits (1)(2)
GER is defined as the passage of gastric contents into the esophagus and oral cavity. This is different than GERD (gastroesophageal reflux disease), which is more troublesome but much more rare.
Gastric reflux is common in infants because the band of muscle, or sphincter, that squeezes the top opening of the stomach shut, does not yet close at full strength, especially in premature babies.
According to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (what a mouthful!), “it is important that all practitioners who treat children with reflux-related disorders are able to identify and distinguish those children with GERD.” (3)
This is important to highlight because the treatment for GERD is more aggressive and could be potentially harmful for those children who only have GER.
How do you treat GER?
Occasional spitting up is not typically a concern; however, if your baby is exhibiting other symptoms such as poor weight gain, it may be time to take action.
Many pediatricians recommend thickening the baby’s formula or breastmilk with rice cereal; however, there are a few things that I recommend trying before resorting to that.
In fact, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition suggests “Dietary Management” before thickening.
So what does “Dietary Management” entail?
The gold standard is what’s called an “elimination and re-challenge protocol,” where you see “full resolution of symptoms via a strict elimination, followed by recurrence [of the symptoms] on reintroduction of cow’s milk protein.
In fact, in one study where 72 children with GERD were treated with medication, 33% did NOT see a reduction in symptoms UNTIL they eliminated cow’s milk for 4 weeks from their diet in which case ALL remaining patients responded well and ALL of their symptoms were resolved. (4)
What if they had skipped the medication and just eliminated cow’s milk in the first place??
According to Dr. Michael Greger, “Even if there’s no formal dairy allergy per se, there appears to be some kind of cow’s milk “hypersensitivity” among many infants and children with severe reflux.” (5)
Removing cow’s milk from mother’s diet or from baby’s diet is a very effective and gentle method and is recommended by many experts. But you may not notice a change overnight in your child. It can take a few weeks to resolve reflux.
What can you do in the meantime?
-Talk to your doctor or Lactation Specialist (if breastfeeding) to discuss possible feeding changes that could benefit your child.
-Reduce caffeine in your diet if breastfeeding
-Reduce spicy foods and/or chocolate if breastfeeding
-Reduce highly acidic drinks such as orange juice, soda, etc if breastfeeding
-Eliminate baby’s exposure to secondhand smoke
And if you’re a geek like me and want to hear about a very fascinating connection between puking gorilla’s and milk, check out my blog at thrivekin.com!
Sources:
1.Nelson SP, Chen EH, Syniar GM, Christoffel KK, Pediatric Practice Research Group. Prevalence of symptoms of gastroesophageal reflux during childhood: a pediatric practice-based survey. Arch Pediatr Adolesc Med. 2000;154(2):150–154pmid:10665601
2. Campanozzi A, Boccia G, Pensabene L, et al. Prevalence and natural history of gastroesophageal reflux: pediatric prospective survey. Pediatrics. 2009;123(3):779–783pmid:19255002
3.https://pediatrics.aappublications.org/content/131/5/e168
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166669/
5. https://nutritionfacts.org/…/treating-reflux-in-babies-wit…/
Questions? Just ask!
Want to work with me 1:1 to create the perfect diet for you and/or your family? Contact me today at dana@thrivekin.com.